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Role of home visiting in improving parenting and health in families at risk of abuse and neglect : results of a multicentre randomised controlled trial and economic evaluation

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Barlow, Jane, Davis , Hilton, McIntosh, Emma, Jarrett, Patricia, Mockford, Carole and Stewart-Brown, Sarah L.. (2007) Role of home visiting in improving parenting and health in families at risk of abuse and neglect : results of a multicentre randomised controlled trial and economic evaluation. Archives of Disease in Childhood, Vol.92 . pp. 229-233. ISSN 0003-9888

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Official URL: http://dx.doi.org/10.1136/adc.2006.095117

Abstract

Objectives – To evaluate the effectiveness and cost-effectiveness of an intensive home visiting programme in improving outcomes for vulnerable families.
Design – Multicentre randomised controlled trial in which eligible women were allocated to receive home visiting (n=67) or standard services (n=64). Incremental cost analysis.
Setting – 40 GP practices across two counties in the UK
Participants – 131 vulnerable pregnant women.
Intervention: Selected health visitors were trained in the Family Partnership Model to provide a weekly home visiting service from 6-months antenatally to 12 months postnatally.
Main outcome measures – mother-child interaction, maternal psychological health attitudes and behaviour, infant functioning and development, and risk of neglect or abuse.
Results – At 12-months differences favouring the home visited group were observed on an independent assessment of maternal sensitivity (p<0.04) and infant cooperativeness (p<0.02). No differences were identified on any other measures. There was a non-significant increase in the likelihood of intervention group infants being the subject of child protection proceedings, or being removed from the home, and one death in the control group. The mean incremental cost per infant of the home visiting intervention was £3,246 (bootstrapped 95% confidence interval for the difference: £1,645 - £4,803).
Conclusion – This intervention may have the potential to improve parenting and increase the identification of infants at risk of abuse and neglect in vulnerable families. Further investigation is needed together with long term follow up to assess possible sleeper effects.

Item Type:

Journal Article

Subjects:

H Social Sciences > HQ The family. Marriage. Woman
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services

Divisions:

Faculty of Medicine > Warwick Medical School

Library of Congress Subject Headings (LCSH):

Home-based family services -- Great Britain, Child abuse -- Great Britain, Problem families -- Great Britain

Journal or Publication Title:

Archives of Disease in Childhood

Publisher:

BMJ

ISSN:

0003-9888

Official Date:

2007

Dates:

Date	Event
2007	Published

Volume:

Vol.92

Page Range:

pp. 229-233

Identification Number:

10.1136/adc.2006.095117

Status:

Peer Reviewed

Publication Status:

Published

Access rights to Published version:

Open Access

Description:

Version accepted by publisher (post-print, after peer review, before copy-editing)

Funder:

Great Britain. Dept. of Health (DoH), Nuffield Foundation (NF)

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URI:

http://wrap.warwick.ac.uk/id/eprint/93

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